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Abstract #0352

Cardiac MRI derived ventricular-arterial coupling ratio predicts myocardial energetics in patients with congenital heart disease

Natasha Banga1,2, Tarique Hussain1, and Maria Gusseva1
1Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States, 2Stanford University, Stanford, CA, United States

Synopsis

Keywords: Myocardium, Cardiovascular

Motivation: Ventricular-arterial coupling (VAC) – a ratio of arterial over ventricular elastance (Ea/Ees) – was found to predict clinical outcomes and was associated with myocardial energetics: stroke work (SW), potential energy (PE).

Goal(s): To compare invasive-VAC (Ea/Ees) with noninvasive-VAC (ESV/SV) ability to predict ventricular efficiency (i.e. SW/SW+PE).

Approach: Biomechanical model of the heart was used to recontract patient-specific pressure-volume (PV) loops from CMR and catheterization data in 30 patients with Fontan circulation, 20 and 16 right and left ventricles of patients with rTOF. VAC and SW/SW+PE were derived from PV loops.

Results: Both invasive-VAC and noninvasive-VAC were strong predictors of ventricular efficiency.

Impact: Ventricular arterial coupling (arterial (Ea)/ventricular (Ees) elastance) was a strong predictor of ventricular efficiency ratio (SW/SW+PE). CMR-derived VAC (ESV/SV) was equivalent to Ea/Es suggesting the potential of ESV/SV to be an important indicator of cardiovascular energetics.

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